Synchronous operable pancreatic and breast cancer without genetic mutation: A literature review and discussion
Publication Details
Ofri, A.,
Zuidersma, D.,
Diakos, C. I.,
Stevanovic, A.,
Wong, M.,
Sood, S.,
Samra, J. S.,
Gill, A. J.,
&
Mittal, A.
(2022).
Synchronous operable pancreatic and breast cancer without genetic mutation: A literature review and discussion.
Frontiers in Surgery, 9.
Abstract
Background: Synchronous cancers are rarely detected when working-up a patient for a primary cancer. Neoadjuvant management of synchronous breast and pancreatic cancers, without a germline mutation, has yet to be discussed. Two patients were diagnosed with synchronous breast and pancreatic cancers at our institution over the last decade. A literature review was performed to evaluate the current evidence stance.
Results: The first patient was 61-years old and diagnosed with a HER2+ breast cancer. The second patient was 77-years old and diagnosed with a Luminal B breast cancer. The inability to provide concurrent breast and pancreatic neoadjuvant therapy for the HER2+ patient, resulted in upfront surgery. The second patient was able to have both cancers treated simultaneously - neoadjuvant chemotherapy to the pancreas, and neoadjuvant endocrine therapy to the breast.
Discuss: There is no single neoadjuvant regimen that treats both pancreatic and breast cancer. The differences in breast cancer sub-types impacted our neoadjuvant options. Our recent experience led us to the hypothesis that breast cancer care dictates treatment, while pancreatic cancer determines survival. There is a significant paucity in the literature regarding synchronous breast and pancreatic cancer.
Keywords
pancreatic cancer, breast cancer, synchronous, non-germline, neoadjuvant treatment
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